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- Article 1: Task Force Fails to Recommend Hearing Loss Screening for Older Adults
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Editor: The U.S. Preventive Services Task Force has studied whether or not to recommend that older people be screened for hearing loss, and their results are inconclusive. Frankly, I'm surprised at this result. I thought there was pretty good evidence that such screening would provide considerable benefit. Below is the Consumer Fact Sheet for the study. That and more information are available at http://www.uspreventiveservicestaskforce.org/uspstf/uspshear.htm

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The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation on Screening for Hearing Loss in Older Adults.

This recommendation is for men and women ages 50 and older. It does not apply to people who notice and are concerned about possible changes in their hearing. They should discuss their symptoms with a health care professional.

The Task Force reviewed research studies on the use of screening tools to identify older adults who might have hearing loss. The recommendation summarizes what it learned about the potential benefits and harms of this screening: There is not enough evidence to determine whether screening helps people who are not aware of hearing loss or who think their hearing is worse but have not chosen to talk to a health care professional about it.

This fact sheet explains the recommendation and what it might mean for you.

What is hearing loss in older adults?

Hearing loss can be caused by various factors. The most common cause is getting older. When a person gets older, special cells in the ear begin to work less well. This kind of hearing loss progresses slowly over time and usually affects both ears. Hearing problems can make it hard to talk to other people and carry out daily activities.

Screening for Hearing Loss

About 20 to 40 percent of adults older than age 50 and nearly 80 percent of adults older than 80 have some hearing loss. Many adults do not choose to get screened or treated for this condition. They may not realize they have hearing loss because it is mild or is getting worse very slowly. Some know they have some hearing loss, but are not bothered by it. Others may have other medical problems that prevent them from realizing they have hearing loss.

Health care professionals use several screening tests to find out whether a person has hearing loss:

• Testing with soft sounds. Can a person hear whispering, fingers rubbing together, or a ticking clock?

• Asking questions. A doctor or nurse may ask, "Do you have difficulty with your hearing?" or ask you to fill out a questionnaire with several questions about your hearing.

• Hand-held audiometer. This instrument measures the ability to hear sounds at different pitches and volumes.

If hearing loss is identified, it often can be treated with a hearing aid. However, only a small number of older adults with hearing loss use a hearing aid. Some may not want or be able to wear a hearing aid because of cost or comfort. Others may not want people to know they have a hearing problem or may have difficulty using a hearing aid.

Potential Benefits and Harms

Screening attempts to detect disease in people who do not know that they have the condition. In the case of hearing loss, screening could lead to earlier detection in people who are not aware that their hearing is changing. It also may detect hearing loss in people who think their hearing may be getting worse but who have not chosen to talk to a health care professional about it. One potential benefit of detecting hearing loss early may be to prevent additional hearing loss through early treatment. Another possible benefit may occur if people who have not recognized their hearing loss or who have not wanted to talk to a health care provider about it discover - after they have been diagnosed and receive a hearing aid - that the untreated hearing loss was having a significant negative effect on their daily life. In both cases, the Task Force did not find enough evidence to prove or disprove that screening would result in these potential benefits.

The Task Force also found little evidence on potential harms. However, it is unlikely that there are important harms associated with screening and treatment for hearing loss, including the use of hearing aids.

The Task Force Recommendation on Screening for Hearing Loss in Older Adults: What Does It Mean?

Here is the recommendation on screening for hearing loss in older adults. The recommendation has a letter grade. The grade is based on the quality and strength of the evidence about the potential benefits and harms of the screening test. It also is based on the size of the potential benefits and harms. Task Force evidence grades are explained in the box at the end of this fact sheet.

When there is not enough evidence to judge potential benefits and harms, the Task Force does not make a recommendation for or against-it issues an I Statement. The Notes next to the recommendation helps to explain key ideas.

Visit the Task Force Web site to read the full recommendation statement on screening for hearing loss in older adults. The statement explains the evidence that the Task Force reviewed and how it decided on the grade. An evidence report on this topic provides more detail about the studies the Task Force considered.

The Task Force concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss in asymptomatic adults age 50 years and older.

Should You Be Screened for Hearing Loss?

Getting the best health care means making smart decisions about what screening tests, counseling services, and preventive medicines to get and when to get them. Many people don't get the tests or counseling they need. Others get tests or counseling they don't need or that may be harmful to them.

Task Force recommendations can help you learn about screening tests, counseling services, and preventive medicines. These services can keep you healthy and prevent disease. The Task Force recommendations do not cover diagnosis (tests to find out why you are sick) or treatment of disease.

How should you decide whether to be screened for hearing loss?

Consider your own health and lifestyle. Think about your personal beliefs and preferences for health care. Talk with your health care professional if you are concerned about your hearing or think your hearing may be getting worse. And consider scientific recommendations, like this one from the Task Force. If you do get a screening test, talk with your health care professional about the results of your test and next steps you may need to take.

What is the U.S. Preventive Services Task Force?

The Task Force is an independent group of national experts in prevention and evidence-based medicine. The Task Force works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, or preventive medicines. The recommendations apply to people with no signs or symptoms of the disease being discussed. Recommendations only address services offered in the primary care setting or services referred by a primary care clinician.

To develop a recommendation statement, Task Force members consider the best available science and research on a topic. For each topic, the Task Force posts draft documents for public comment, including a draft recommendation statement. All comments are reviewed and considered in developing the final recommendation statement. To learn more, visit the Task Force Web site.

USPSTF Recommendation Grades
A - Recommended.
B - Recommended.
C - Recommendation depends on the patient's situation.
D - Not recommended.
I statement - There is not enough evidence to make a recommendation.

Source: U.S. Preventive Services Task Force

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- Article 2: HLAA Announces New Board President
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Diana D. Bender, Ph.D., from Phoenixville, Pennsylvania, has been named president of the Board of Trustees of the Hearing Loss Association of America(r) (HLAA), the nation's largest organization for people with hearing loss. She officially assumed her new role at Convention 2012 in Providence, Rhode Island, in June. Other officers installed at the Convention were: Vice President James J. DeCaro, Ph.D., NY; Treasurer Roy Kulick, M.D., OH; and Secretary Zachary S. La Fratta, CO. Nancy R. Peterson from Pennsylvania joined the Board as a new member. She is VP/Deputy General Counsel and Chief Compliance Officer of AlliedBarton Security Services.

Diana Bender was born in Brooklyn, and grew up in Mineola, New York. She graduated in 1961 from Bucknell University in Lewisburg, Pennsylvania, with a bachelor of science degree in chemistry. She received her master's (1964) and doctoral (1967) degrees in organic chemistry at the University of Munich, in Munich, Germany. She investigated new cancer drugs as a post-doctoral fellow in the laboratory of Dr. K.C. Tsou at the University of Pennsylvania from 1968 until 1970. After the birth of her first son, she was a full-time homemaker and volunteer.

She returned to the academic world in 1979, working on palladium-catalyzed coupling reactions as a post-doctoral fellow with Dr. Richard Heck at the University of Delaware. Dr. Heck was awarded the Nobel Prize in chemistry for his many years of research in this field in 2010. Beginning in 1980, Diana worked as a research chemist and product manager in the Agricultural Products division of Rohm and Haas Company, a Philadelphia-area specialty chemicals company. She retired in 2001 when the Agricultural Products division was sold to Dow Chemical Company.

Diana was first diagnosed with a progressive hearing loss at the age of 10 and began wearing a hearing aid at the age of 15. She received a cochlear implant in 2004. She has been a member of Hearing Loss Association of America (HLAA) since 1995. She served as president of the Montgomery County Chapter in Lafayette Hill, Pennsylvania, from 1997-2001 and has been the editor of that chapter's newsletter since 1997. She has been a member of the Hearing Loss Association of PA (HLA-PA) Advisory Council since the Pennsylvania state office was established in 2001 and served as the state director of HLA-PA from 2003-2011. From 2004-2006 she represented HLAA on the Courthouse Access Advisory Committee, a committee convened by the U.S. Access Board. She has served on several state advisory committees in Pennsylvania and is a graduate of the Gallaudet University Peer Mentoring Program. She began serving on the HLAA Board of Trustees in 2009 and was elected secretary in 2010 and president in 2012.

Diana says, "I am deeply honored and humbled to have been chosen to serve as president of the HLAA Board of Trustees for the next two years. I look forward to working towards the day when Rocky Stone's vision of opening the world of communication to people with hearing loss through information, education, advocacy, and support becomes a reality, not for just a few, but for all people who have a hearing loss."

About Hearing Loss Association of America (HLAA)

HLAA opens the world of communication to people with hearing loss through information, education, support, and advocacy. HLAA's Walk4Hearing(r) is the largest walk of its kind in the country that raises awareness and helps to eradicate the stigma associated with hearing loss. Walks are held in multiple cities across the country. Since 2006, more than 26,000 walkers have stepped up and helped raise funds for programs and services for people with hearing loss and their families. In addition to the Walk4Hearing, HLAA publishes Hearing Loss Magazine, holds annual Conventions (Convention 2013, Portland, Oregon, June 27-30), and has an extensive network of chapters and state organizations. The headquarters is located at 7910 Woodmont Ave., Suite 1200, Bethesda, MD 20814. Phone: 301.657.2248.

Source: HLAA

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- Article 3: Deafened Birds Can't Sing
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Portions of a songbird's brain that control how it sings have been shown to decay within 24 hours of the animal losing its hearing.

The findings, by researchers at Duke University Medical Center, show that deafness penetrates much more rapidly and deeply into the brain than previously thought. As the size and strength of nerve cell connections visibly changed under a microscope, researchers could even predict which songbirds would have worse songs in coming days.

"When hearing was lost, we saw rapid changes in motor areas in that control song, the bird's equivalent of speech," said senior author Richard Mooney, PhD, professor of neurobiology at Duke. "This study provided a laser-like focus on what happens in the living songbird brain, narrowed down to the particular cell type involved."

The study was published in Neuron journal online on March 7, 2012.

Like humans, songbirds depend on hearing to learn their mating songs - males that sing poorly don't attract mates, so hearing a song, learning it, and singing correctly are all critical for songbird survival. Songbirds also resemble humans and differ from most other animals in that their songs fall apart when they lose their hearing, and this feature makes them an ideal organism to study how hearing loss may affect the parts of the brain that control vocalization, Mooney said.

"I will go out on a limb and say that I think similar changes also occur in human brains after hearing loss, specifically in Broca's area, a part of the human brain that plays an important role in generating speech and that also receives inputs from the auditory system," Mooney said.

About 30 million Americans are hard of hearing or deaf. This study could shed light on why and how some people's speech changes as their hearing starts to decline, Mooney said.

"Our vocal system depends on the auditory system to create intelligible speech. When people suffer profound hearing loss, their speech often becomes hoarse, garbled, and harder to understand, so not only do they have trouble hearing, they often can't speak fluently any more," Mooney said.

The nerve cells that showed changes after deafening send signals to the basal ganglia, a part of the brain that plays a role in learning and initiating motor sequences, including the complex vocal sequences that make up birdsong and speech.

Although other studies had looked at the effects of deafening on neurons in auditory brain areas, this is the first time that scientists have been able to watch how deafening affects connections between nerve cells in a vocal motor area of the brain in a living animal, said Katie Tschida, PhD, a postdoctoral research associate in the Mooney laboratory who led the study.

Using a protein isolated from jellyfish that can make songbird nerve cells glow bright green when viewed under a laser-powered microscope, they were able to determine that deafening triggered rapid changes to the tiny connections between nerve cells, called synapses, which are only one thousandth of a millimeter across.

"I was very surprised that the weakening of connections between nerve cells was visible and emerged so rapidly -- over the course of days these changes allowed us to predict which birds' songs would fall apart most dramatically," Tschida said. "Considering that we were only tracking a handful of neurons in each bird, I never thought we'd get information specific enough to predict such a thing."

The research was supported by the National Science Foundation and the National Institute on Deafness and Other Communication Disorders.

Source: Duke University

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- Article 4: Short Takes
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Editor: Here are our picks of some additional stories that you may find interesting. For more, please point your browser to: http://www.hearinglossweb.com/news/curr.htm

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Genetic Testing Can Explain Hearing Loss and Guide Therapy

Audiologists have been predicting for years that a single blood sample would be used to quickly detect a multitude of underlying genetic causes for hearing loss. A test at the University of Iowa in Iowa City does just that, screening genome sequences associated with syndromes ranging from Pendred to Usher and for genes linked to hearing deficits. What does this advance mean to those who treat the hearing impaired? A lot, said Jeff Simmons, who coordinates the Cochlear Implant Center at Boys Town National Research Hospital in Omaha, NE. "I think it has multiple uses," he said, aside from being able to pinpoint a cause. "From a clinician's point of view, [genetic testing] can help tell us where we want to go in terms of remediation."

http://tinyurl.com/cb85nqs

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Brain Plasticity an Obstacle for Cochlear Implant Rehabilitation

The visual takeover of the cortices typically associated with audition represents a cerebral ability to adapt to change, but it raises an important question regarding the recovery of hearing functions. The question of auditory function following deafness bears special importance for audiologists, given that profound deafness is sometimes reversed with a cochlear implant (CI). One may wonder how these two modalities interact during tasks that require multisensory processing, such as speech perception, if visual input is redirected to auditory cortical areas. Most speech understanding occurs in a multisensory environment in which visual and auditory cues are present. Given the attack of the auditory cortex by visual information following deafness, it can be hypothesized that visual information may interfere with auditory treatment. This interference could lead to poor speech recognition in some CI patients, namely those who have undergone more adaptive plasticity during the period of auditory deprivation (i.e., before implantation).

http://tinyurl.com/9pa8k8p

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Research center to improve reading in children with hearing loss

For many years, parents and educators have been concerned about the low levels of reading skills of some children who are deaf or hard of hearing. The College of Education (COE) at Georgia State University (GSU) is planning to change that. GSU has just been awarded a $10 million grant in order to establish the first national researchcenter that focuses on improving the reading skills of children with hearing loss. According to Gallaudet University's report,Reading Research & Deaf Children, deaf children only achieve a Grade 3 or Grade 4 reading level on average by the age of 18. Studies show that hearing loss does impact reading skills, with children with mild hearing loss tending to have higher reading levels than children with more profound hearing loss.

http://tinyurl.com/bo32bwu

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GLAD is an Affirmative Action Employer with equal opportunity for men, women and people with disabilities. For more information on the following positions, please go to: www.gladinc.org. The status of all positions is: Regular, Full-time, Non-Exempt, Full Fringe Benefits unless otherwise noted. All positions are open until filled.

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